Diabetic retinopathy in pregnancy

A recent nationwide registry study of women with type 1 diabetes, pregnant women, and retinopathy-matched, nonpregnant control participants had a similar risk of developing sight-threatening diabetic retinopathy (DR).¹

The objective of the study was to evaluate the risk of treatment of sight-threatening DR, defined as panretinal photocoagulation for proliferative DR or anti-VEGF injections for diabetic macular edema (DME) during and after pregnancy, compared to nonpregnant control participants.¹

Using the national Danish Registry of Diabetic Retinopathy during and after pregnancy, investigators created a matched cohort study of women with type 1 diabetes who gave birth in 2013-2022. A total of 1,041 pregnant women and 1,041 matched control participants were included. The data were collected from relevant national registers from 36 months before pregnancy until 36 months after pregnancy.¹

At baseline, the median duration (interquartile range [IQR]) of diabetes was 13 (6, 19) and 10 (5, 17) years for cases and control participants. Median baseline HbA_1c (IQR) was 57 (50, 67) compared with 64 (55, 79) mmol/mol (7.4% vs. 8%), and DR was present in 42.7% of both groups.¹

Investigators found that treatment of proliferative DR with panretinal photocoagulation occurred to a similar extent in both pregnant women vs. control participants during and after pregnancy. During treatment: 1.2% vs. 1.1%, respectively, OR 1.18 [95% CI 0.53, 2.66]); and after treatment: 2.7% vs. 2.9%, respectively, OR 0.93 [95% CI 0.55, 1.57]).¹ Treatment of DME was rare in both groups. Progression to proliferative DR was not higher in the pregnant group (adjusted hazard ratio 0.64 [95% CI 0.32, 1.31]).¹

Reference:

1. Sight-Threatening Diabetic Retinopathy During and After Pregnancy – A Nationwide Matched-Cohort Study. Published August 26, 2025. Accessed September 2, 2025. https://diabetesjournals.org/care/article/doi/10.2337/dc25-0758/163308/Sight-Threatening-Diabetic-Retinopathy-During-and